Doctor stresses importance of colon cancer screening

FARMINGTON — March is colorectal cancer awareness month, and a local gastroenterologist wants to get the word out about the importance of being screened.

Colorectal cancer is the second most common cause of cancer deaths in the United States, following lung cancer.

Every year, about 140,000 Americans are diagnosed with colorectal cancer, and more than 50,000 people die from it.

Dr. Armando Lopez de Victoria, with Advanced Gastroenterology Associates on N. Butler, said that by the time he sees many colorectal cancer patients for the first time, it is too late.

"Many of the symptoms of colorectal cancer are the same symptoms that everyone gets every now and then," which causes them to delay seeking treatment, he said.

Symptoms such as anal bleeding, diarrhea or constipation, stomach pain and unexplained weight loss are often seen as minor inconveniences and not as signs that something more serious may be going on.

"Patients feel these symptoms are not significant, and often by the time I see them the cancer is very advanced at the time of diagnosis," he said.

Lopez explained that 95 percent of the colorectal cancers are known as "sporadic," meaning that they are not genetically passed down from a relative. This type of cancer is usually diagnosed when the patient is 65 or 70 years old.

The other five percent of colorectal cancers are genetic and run in families. This type usually develops before the age of 50.

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If a family member has the genetic mutation for colon cancer, relatives should be monitored closely.

"Ninety five percent of colon cancers begin as a polyp, which is a very small growth, similar to a wart," Lopez said. "There are usually no symptoms at this stage, and the patient will not know they have cancer. It's a very slow-growing cancer."

The most accurate screening procedure used to detect these small polyps is a colonoscopy, which can spot the polyps before they turn cancerous. Most polyps detected in a colonoscopy are non-cancerous, but certain polyps, called adenomas, have the potential to become cancerous.

To prepare for a colonoscopy, the patient undergoes a "bowel prep" the night before, which involves drinking a liquid to clear the bowel of fecal matter. While the patient is sedated, the doctor views the colon with a video scope camera, and any polyps that are discovered are immediately removed with a small tool to be biopsied later. Patients normally are sedated and do not remember the procedure.

If a non-cancerous or pre-cancerous polyp is found during a colonoscopy, the patient will need to be re-screened every five years.

If multiple polyps are found, or if a more aggressive polyp called villous adenoma, which can turn malignant, is discovered, the patient will need to be re-screened every three years.

"The polyps are very slow-growing, so that's why patients don't need to be screened every year," Lopez said.

Routine screening for individuals who do not have relatives diagnosed with colorectal cancer should start at age 50, and screening should be repeated every ten years. For those with relatives who have been diagnosed with colorectal cancer, screening should begin at age 40, or 10 years prior to the age of the relative when he or she was diagnosed.

Lopez stresses that anyone who exhibits symptoms should be seen immediately, even if they were recently screened.

"The procedure can be repeated at any time, and it's not 100 percent effective, so it's very important for patients who experience any sudden change in bowel habits, rectal bleeding or blood in the stool, unexplained weight loss associated with abdominal pain or diarrhea or anemia, to see a doctor. Any sort of bleeding, even if the patient thinks it's just from hemorrhoids and even if the patient is very young, should be evaluated."

Lopez said there are some alternatives to performing a colonoscopy when it comes to screening for colorectal cancer.

"There are stool and blood tests also, and Medicare and most insurance plans do cover this type of screening. With Obamacare, people can have this done without money from their pockets."

Despite the screening being covered by most plans, Lopez said patients are still not coming in as often as they should, and stresses that women, as well as men, need to be screened.

"This is an equal-opportunity cancer, affecting women and men at the same rate. Women should think of this screening the same way they think of mammography or pap screens, it's the same concept," Lopez said.

Fran Robinson is the Cancer Navigator at San Juan Regional Cancer Center. Robinson said the hospital is also trying to get the word out that anyone 50 or older needs to have a colorectal cancer screening test.

"The screening tests can find polyps so they can be removed before they become cancer," she said. "They (the tests) also find the cancer early, when the chance of being cured is very good."

Robinson said the Cancer Center offers presentations on the importance of colorectal screening, and anyone wishing to schedule a presentation for a business or community group can do so by calling 505-609-6089.